The most common congenital heart defects are usually diagnosed as soon as the baby is born. Some of them are life-threatening to the newborn and are therefore treated surgically. However, some congenital heart defects may not show any clinical symptoms for a long time, and are therefore only detected in adults. Check out the most common congenital heart defects in children and adults.

The most common congenital heart defectsare ventricular septal (VSD) and interatrial septum (ASD) defect, patent ductus arteriosus (PDA), as well as aortic coarctation (CoA), critical stenosis the pulmonary valves (PS) and the aortic valves (AS) and the tetralogy of Fallot (ToF).

Congenital heart defectsare structural abnormalities in the structure of the heart and disturbances in the position of the heart and the great vessels in the chest. They affect an average of 1 in 100 children worldwide, regardless of latitude. In Poland, they are one of the most common congenital abnormalities and, after perinatal diseases, the most common cause of infant death, according to a report by the "Children's Heart" Foundation.

Congenital heart defects: ventricular septal defect

The essence of the disease is a left-right leak at the ventricular level - blood flow from the left ventricle to the left atrium.

The spontaneous closure of the ventricular septal defect occurs most often during the first 2 years of life. Otherwise, characteristic symptoms appear in both children and adults. It is assumed that the greater the defect in the septum, the more numerous the clinical symptoms. Small changes do not show any symptoms (only when auscultating the patient, a murmur in the heart may be heard - in the left side and bottom of the sternum).

In adults (in about 10% of adult patients with congenital heart disease), when leakage (mixing of venous and arterial blood) increases from the left ventricle to the right, problems appear during feeding, and thus - too slow weight gain. You may notice breathing problems and symptoms of heart failure. Recurring respiratory infections also occur in the event of significant leakage.

It is estimated that the ventricular septal defect accounts for approximately 20 percent of all congenital heart defects.

Read also: Whattests will help diagnose a heart defect? ​​

Congenital heart defects: atrial septal defect

The defect in the atrial septum results from abnormalities in the development of the atrial septum and may occur in different parts of the septum. Most often, however, it appears in the place where the so-called oval hole.

Every day in Poland 10 children are born with a heart defect, 1/3 of which requires surgery in the first days of life.

Small cavities usually do not give any symptoms and close by themselves within a few months of the birth of a child with this defect. Symptoms of major changes in the atrial septum are heart murmurs (detectable during auscultation of the patient) and recurrent respiratory infections.

Large cavities are an indication for surgical treatment. It is necessary to prevent later arrhythmias and heart failure.

Patent foramen ovaleis much less common (it accounts for about 7-12 percent of all congenital heart defects). At the same time, it is the most common type of congenital heart defect in adults, as it does not give any clinical symptoms for a long time or they are practically imperceptible.

According to an expert prof. dr hab. n. med. Bohdan Maruszewski, pediatric cardiac surgeon, head of the Department of Cardiac Surgery, Children's Memorial He alth Institute

[…] The specificity of Polish pediatric cardiac surgery is the fact that newborns and children are born and are treated surgically with all the most complex types of congenital heart defects, including single-chamber hearts. […] The results of treatment of children with congenital heart disease are statistically analyzed in detail in Poland and compared both between national centers and with European and world data. They are very good and result from the concentration of the most difficult cases in the largest centers.

Congenital heart disease: patent ductus arteriosus Botalla

The Botalla ductus arteriosus is a blood vessel in the fetus that connects the left pulmonary artery directly to the aorta so that the blood passes the pulmonary vessels (the fetus does not breathe through the lungs, therefore no blood is transported from the heart to the lungs).

Normally, this tube closes on its own within 24 hours of the newborn's first inhalation, as it ceases to function as intended. When it does not close, blood from the left ventricle, instead of flowing into the aorta and then into the tissues of the entire body, flows into the pulmonary artery and into the lungs. Then we are talking about the patent ductus arteriosus.

More surgeries for birth defects are performed in Polandhearts in children per 1 million inhabitants than in Germany.

Symptoms of lung burden with excessive blood volume appear about 3-5 days after birth. These are tachycardia, which is an accelerated heartbeat, a soft and soft murmur heard at the top of the sternum. When the leakage is high, the child grows poorly, develops with a delay, and often struggles with inflammation of the lower respiratory tract.

It is imperative to close the tube during surgery to prevent damage to the heart and lungs.

This defect often coexists with other defects in the structure of the heart. As an isolated defect, it accounts for about 10 percent of all congenital heart defects.

Worth knowing

There are 9 pediatric cardiac surgery centers in Poland, including one non-public, where a total of 2,730 congenital heart disease operations are performed annually. In this respect, Polish pediatric cardiac surgeons are leaders in Europe.

The three centers most experienced in the operation of congenital heart defects in children are the Children's He alth Center in Warsaw, the Polish Mother Center in Łódź and the University Children's Hospital in Kraków-Prokocim. These 3 centers belong to the group of the so-called High Volume Centers that provide over 350 congenital heart disease surgeries per year.

Congenital heart disease: aortic stenosis

The aorta (the largest artery) and its branches carry blood around the body. In the case of its narrowing in the section not far from the exit from the heart, the organs below the narrowing cannot function properly because they are insufficiently supplied with blood. Then we talk about aortic stenosis.

The main problems that parents of children with heart defects pay attention to is access to cardiac rehabilitation and effective prophylaxis in the fight against respiratory infections.

The disorders affect the lower body, therefore worse development of the legs is noticeable. The most common symptoms are weak heart rate in the arteries below the narrowing (in the thighs) and normal or high heart rate in the arms. Cyanosis appears on the legs that grow worse and are cold. The internal organs are also affected by worse blood supply, which is why the kidneys are disturbed.

There may also be headaches, nosebleeds, and even angina and heart failure.

The treatment consists in dilating the narrowed aorta with a special balloon or using a vascular stent to expand the vessel. In some cases, surgical treatment is necessary, the aim of which is to excise the stricture and join the resulting two parts of the aorta.

Aortic stenosis, or aortic coarctation, accounts for 8-10% of all defectscongenital heart.

According to an expert prof. dr hab. n. med. Bohdan Maruszewski, pediatric cardiac surgeon, head of the Department of Cardiac Surgery, Children's Memorial He alth Institute

The number of adult and adolescent patients after various types of operations for congenital heart defects is increasing

A growing problem in the scale of the entire country, where more operations of congenital heart defects are performed in children per 1 million inhabitants than in Germany, is the growing number of adult and adolescent patients after various types of congenital heart defect surgery.

These patients belong to the so-called by GUCH, Grown Up with Congenital Heart Disease. The number of these patients is estimated at 80-100 thousand. They require specialist care resulting from surgery and cardiological interventions, many of them have various problems with cardiac arrhythmias, many require late reoperations, diagnostic tests, as well as all acquired cardiological problems of mature age, including ischemic heart disease.

These patients need an organized system of multidisciplinary medical care, with experience in both the treatment of congenital heart defects and adult cardiology. Unfortunately, we do not currently have such a system, apart from 2 centers, i.e. the Institute of Cardiology in Warsaw and the Silesian Center for Heart Diseases in Zabrze.

Congenital heart disease: critical stenosis of the pulmonary valve

Pulmonary valve stenosis, orpulmonary valve stenosis , prevents blood from flowing freely from the right ventricle. As a result, there is an increase in the load on the right ventricle and its hypertrophy. Patients, especially with severe stenosis, complain of shortness of breath, rapid fatigue after exercise, dizziness, visual disturbances. A weak weight gain is also noticeable. Fainting happens. There are also symptoms of right ventricular failure with peripheral edema.

Most patients require treatment in the first years of life. It consists in widening the valve with a special balloon, sometimes eventually replacing it with a prosthesis.

Read also: Heart disease prevention: advice for a busy heart

Other congenital heart disease

Critical aortic stenosis

In this case, blood cannot flow freely from the left ventricle into the aorta. It is related to the reduction of the area of ​​the opening between the left ventricle and the aorta. Most often it is an acquired defect caused by degeneration of valve leaflets or rheumatic disease.Congenital valve stenosismay be caused by a bicuspid valveaorta. The clinical symptoms are the same as those of pulmonary valve stenosis. Treatment is similar to that for pulmonary valve stenosis.

Tetralogy of Fallot

This is a complex and quite complicated flaw. It consists of four disorders: ventricular septal defect, right ventricular hypertrophy, pulmonary artery stenosis, and right aortic displacement above the ventricular septum opening. The symptoms are serious, cyanosis appears quickly. Surgical intervention is necessary, usually in several stages.

Tetralogy of Fallot is diagnosed in approximately 10% of infants with congenital heart disease. It is the most common form of cyanotic heart disease in adults.

Replication of great arterial trunks

Large arteries coming out of the heart are messed up. The aorta departs not from the left, but from the right ventricle, and the pulmonary artery not from the right, but from the left ventricle. Two independent closed blood circuits then arise. In one, deoxygenated blood circulates constantly (supplies the entire body except the lungs). In the second, only oxygenated blood (it flows continuously to the lungs and returns to the heart).

Treatment is to maintain blood flow through the leaks that exist in utero: the arterial duct and the atrial opening. This gives doctors the opportunity to prepare the child for surgery to correct the position of the arteries.

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Cardiology